Introduction to part I: The hypothesis testing model - a summary of the introduction to Conducting psychological assessment by Wright, A. J.

Conducting psychological assessment
Wright, A. J. (2011)
Introduction to part I: The hypothesis testing model.

Introduction

At its most basic, psychological assessment provides a catalogue of an individual’s cognitive, emotional, and psychological strengths, weaknesses, deficits, and resources.
At its best, it provides dynamic insights into the inner workings of an individual, yielding invaluable information for diagnosis, potential intervention and prognosis.

Psychological assessment should be used to help answer whatever referal questions are present and to make clear and specific recommendations to help the individual being assessed function better in his or her life.
The central goal of making useful (and realistic) recommendations should never be forgotten.

Six major processes that make up any psychological assessment

  1. Conducting a clinical interview
  2. Choosing a battery of tests
  3. Administering, scoring, and interpreting tests
  4. Integrating and conceptualizing information gathered from test results, the clinical interview, behavioural observations, and other sources
  5. Writing a psychological assessment report
  6. Providing feedback to the individual assessed and/or the referral source

The hypothesis testing model

The importance of psychological assessment lies in the fundamental assumption that there are aspects of our functioning that we are not entirely aware of or cannot effectively articulate.

It is important to not that testing and assessment provide a picture of how the individual being assessed is currently functioning. It measures individuals at that particular moment in time.

There is no perfect measure.
The hypothesis testing model uses the strengths of each individual test, as well as clinical acumen, while assuming that each individual measure is flawed.
Each individual assessment can be treated as a research study by

  • Making hypotheses and testing them to rule out possibilities and incorporate others
  • Using multiple tests and multiple methods, which provide more solid data and allow he assessor to be much more confident in his or her findings

Step 1: Clinical assessment

The first step of the hypothesis testing model is to conduct a thorough clinical interview.
You will then use the results of this interview, together with background information collected from various sources, to create hypothesis.
Clinical assessment: a combination of the information gathered from the clinical interview and other sources of report.
Clinical assessment has two goals

  • Assessing impairment in functioning
    While some impairments may be overly evident, there are often more subtle impairments in functioning.
    Assessments are not entirely about weakness and impairment.
    • It is also a clear survey of what’s going right.
  • Generating hypothesis
    For this, a thorough understanding of psychodiagnosis is necessary.
    General theories of behaviour, regardless of theoretical orientation, are also extremely important.
    Based on ‘findings’ of the clinical assessment, you should list all possible causes of the functional impairment.

Step 2: Selecting tests

Based on the hypothesis generated in step 1, the assessor selects a testing battery.
Tests should be chosen based on an established set of criteria, which should include their own internal psychometric properties, what exactly they assess, and how they assess it.
Great care should be taken to include multiple measures of the same constructs. These can be combined later with the clinical interview data and behavioural observations to make assertions about whether there is evidence for or against hypothesis.

Step 3: Testing

No test is perfect. Having more data is better.

After choosing a testing battery, administration and scoring of the chosen tests are the next steps.
These are perhaps two of the most important steps in the entire process.
The strictest discipline should be used in making sure that all tests are administered and scored in their appropriate, standardized way.
As assessment is a stepwise, hierarchical process, all steps after administration and scoring of the tests are predicated on the assumption that administration and scoring are absolutely correct and valid.

It is vital to know the limitations of each test, so that interpretation does not overstep the bounds of what each individual test is able to do.

Step 4: Integration of all data

This step is where test results and behavioural observations are combined with clinical assessment data to address each of the hypothesis.
Every hypothesis generated should be addressed by the testing process.
In addition to integrating all of the data collected into themes, the process of fitting the themes together into a coherent narrative is presented.
The end result is that the individuals being assessed and the referral sources will be more likely to take the recommendations made at the end of the report

Step 5: Writing the assessment report

You have to find a balance between using professional language while not using too much psychological jargon.

Step 6: Providing feedback

No consistent model for providing feedback has been developed and adopted widely throughout the field.
In general, feedback should be provided at a level that, as with the write-up, is both professional and understandable.
This means that based on the assessment itself and the individual being assessed, feedback sessions should be both specifically tailored and understandable.
An assessor must be able to be flexible throughout a feedback session, given that individuals’ reactions to feedback are as varied as individuals themselves.

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